A novel muscle cramp scale (MCS) in amyotrophic lateral sclerosis (ALS).

Objective: To develop a novel muscle cramp scale (MCS) to assess frequency, severity and clinically meaningful information related to cramps among patients with amyotrophic lateral sclerosis (ALS). Methods: This new scale comprises four 5-point subdomains: (1) triggering factors, (2) frequency, (3) location, (4) severity, and (5) the degree to which cramps affect overall daily living. Thirty patients with ALS, who experienced at least 5 cramps per week, participated in a randomized test-retest study. An additional 26 patients participated in a second study assessing cramp changes over 4 weeks using the MCS and a detailed cramp diary. Results: To establish internal reliability of the scale, a Cronbach's coefficient value of 0.75 or higher was considered acceptable. Test/retest evaluations comparing in-person and telephone administration were assessed using paired t-tests and Cohen's kappa statistics. Non-significant differences were identified, and the results revealed moderate to high agreement for each item (range 0.60 to 0.95, p < 0.0001). Scale construct validity against the cramp diary was acceptable. There were essentially no significant mean differences in muscle cramps over 4 weeks measured using the MCS and diary, respectively. Conclusions: The MCS is a valid, simple, and quick measure for the assessment of muscle cramps in patients with ALS. It can be reliably administered either in person or by telephone and provides richer information than the routinely utilized cramp diary.

Working memory capacity is associated with optimal adaptation of response bias to perceptual sensitivity in emotion perception.

Emotion perception, inferring the emotional state of another person, is a frequent judgment made under perceptual uncertainty (e.g., a scowling facial expression can indicate anger or concentration) and behavioral risk (e.g., incorrect judgment can be costly to the perceiver). Working memory capacity (WMC), the ability to maintain controlled processing in the face of competing demands, is an important component of many decisions. We investigated the association of WMC and anger perception in a task in which "angry" and "not angry" categories comprised overlapping ranges of scowl intensity, and correct and incorrect responses earned and lost points, respectively. Participants attempted to earn as many points as they could; adopting an optimal response bias would maximize decision utility. Participants with higher WMC more optimally tuned their anger perception response bias to accommodate their perceptual sensitivity (their ability to discriminate the categories) than did participants with lower WMC. Other factors that influence response bias (i.e., the relative base rate of angry vs. not angry faces and the decision costs and benefits) were ruled out as contributors to the WMC-bias relationship. Our results suggest that WMC optimizes emotion perception by contributing to perceivers' ability to adjust their response bias to account for their level of perceptual sensitivity, likely an important component of adapting emotion perception to dynamic social interactions and changing circumstances. (PsycINFO Database Record

Pediatric Pain Screening Tool: rapid identification of risk in youth with pain complaints.

Moderate to severe chronic pain is a problem for 1.7 million children, costing $19.5 billion dollars annually in the United States alone. Risk-stratified care is known to improve outcomes in adults with chronic pain. However, no tool exists to stratify youth who present with pain complaints to appropriate interventions. The Pediatric Pain Screening Tool (PPST) presented here assesses prognostic factors associated with adverse outcomes among youth and defines risk groups to inform efficient treatment decision making. Youth (n = 321, ages 8-18, 90.0% Caucasian, 74.8% female) presenting for multidisciplinary pain clinic evaluation at a tertiary care center participated. Of these, 195 (61.1%) participated at 4-month follow-up. Participants completed the 9-item PPST in addition to measures of functional disability, pain catastrophizing, fear of pain, anxiety, and depressive symptoms. Sensitivity and specificity for the PPST ranged from adequate to excellent, with regard to significant disability (78%, 68%) and high emotional distress (81%, 63%). Participants were classified into low- (11%), medium- (32%), and high- (57%) risk groups. Risk groups did not significantly differ by pain diagnosis, location, or duration. Only 2% to 7% of patients who met reference standard case status for disability and emotional distress at 4-month follow-up were classified as low risk at baseline, whereas 71% to 79% of patients who met reference standard case status at follow-up were classified as high risk at baseline. A 9-item screening tool identifying factors associated with adverse outcomes among youth who present with pain complaints seems valid and provides risk stratification that can potentially guide effective pain treatment recommendations in the clinic setting.